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All Journal International Journal of Integrated Health Sciences Medical Journal of Indonesia The Indonesian Biomedical Journal Paediatrica Indonesiana Medicinus : Jurnal Kedokteran Neurologico Spinale Medico Chirurgico Jurnal Ilmu Bedah Indonesia
Julius July
Department Of Neurosurgery, Faculty Of Medicine, Pelita Harapan University, Neuroscience Center, Siloam Hospital Lippo Village, Tangerang, Banten
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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The Profile of P63 Expression and Epstein-Barr-Encoded RNA (EBER) Distribution in Primary Central Nervous System Lymphoma: A Retrospective Bi-Center Study Kristiani, Erna; Marisca, Stephanie; Suharyani, Sally; Dermawan, Kevin; Widodo, Stephanie T.; Ham, Maria F.; Harahap, Agnes S.; Susanto, Eka; Tjahjadi, Hartono; July, Julius
Medicinus Vol. 14 No. 2 (2025): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i2.9545

Abstract

Background : Primary central nervous system lymphoma (PCNSL) is a type of lymphoma occurring around 0.5 – 1.2% of all intracranial neoplasms. However, recent epidemiological research shows a threefold increase in the number of cases. The Epstein-Barr virus (EBV) and PCNSL are both associated with the condition of immunosuppression or immunodeficiency, which often found to have a significant relationship with each other. Moreover, the TP63 mutation is associated with a poor prognosis. Methods : This is a descriptive study to assess the expression of TP63 and EBER on PCNSL, and present the characteristics of the disease. The study was conducted on 25 cases from two health centers with the most cases of brain tumors in Indonesia, Siloam Hospital Lippo Village and Cipto Mangunkusumo Hospital (CMH) from 2014 to 2018, the P63 expression and EBER-1 examinations were done by 4 pathologists. A total of 25 patients, 13 (52%) patients were male, ranging from age 30 – 79, with average 57,6 years old, located mostly in the frontal lobe in 8 patients (30.9%). Result : From the research results obtained positive P63 results in 20 cases (80%), while the EBER test was negative for all 25 patients. Further analysis with software SPSS 25 proving that P63 expression is not associated with germinal center B-cell type (GCB) or non-GCB type (p-value 0,87). Neither, P63 have any association with Ki67 with p-value of 1.00. Conclusions : This study concludes that there is a possibility that PCNSL cases in Indonesia are not associated with Epstein-Barr virus infection, but most of the cases will have a poor prognosis as indicated by P63 expression.
The Key role of MRI modalities in En Plaque Meningioma Tirtaprawita, Novita; Wiradharma, Wiradharma; July, Julius
Medicinus Vol. 6 No. 2 (2017): February 2017 - May 2017
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v6i2.1145

Abstract

En plaque meningioma is at frontal region is difficult to be differentiated from osteoma, based on CT scan only. En plaque meningioma represents in 2-9% of all meningioma cases. Usually en plaque meningioma grows on the sphenoid wing, whereas only 1 % grows on the frontal and temporal bone. This case is female 37 year- old who presents with chronic headache and huge lump on her right forehead that she believes it slowly enlarges for the last 5 years. The Computerized Tomography scan (CT scan) shows thickening of the right fronto-temporal bone (3-4 cm) with the diameter of 12 cm and bony hard. Initial impression suggests it could be osteoma or fibrous dysplasia. After the MRI (Magnetic Resonance Imaging) with contrast, it shows a carpet like tumor underline the thickening bone, and it suggest an en plaque meningioma. For en plaque meningioma, we have to remove the abnormal duramater. We suggest that for a case with a wide thickening calvarian bone, it’s better to get the MRI of the head with contrast.
The Importance of Immunohistochemical Analysis in Silent Pituitary Adenoma Harsono, Ivan William; Stevina, Nathania Victoria; Puspitasari, Vivien; July, Julius
Medicinus Vol. 6 No. 3 (2017): June 2017 - September 2017
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v6i3.1150

Abstract

Pituitary adenoma contributes to 15% of all intracranial neoplasm. It is usually following benign course and some of them are silent (asymptomatic clinically, but hormone-secreting). Silent adenoma usually found incidentally or when the patients show mass effect (neurological deficits). Many of histologically aggressive silent adenoma subtypes are associated with invasiveness, recurrence and progression to clinically functioning adenomas. Aggressive silent adenoma radiologically tends to invade in downward direction, invading bone, sinus cavernosus, parasellar region. The nature of aggressive silent adenoma subtypes is differing in nature compared to benign nature of pituitary adenoma and should be confirmed immunohistochemically to determine the prognosis and anticipate the risk of recurrence or progression. The case illustration show a real case of 46 years old female progressive headache and visual disturbance diagnosed with non-functional pituitary macroadenoma but positive for more than one immunochemistry biomarker (plurihormonal aggressive silent adenoma).
IL-4: PREDIKTOR ANTI INFLAMASI PADA STROKE ISKEMIK ? Herminawati, Lucia; July, Julius
Medicinus Vol. 5 No. 1 (2015): October 2015 - January 2016
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v5i1.1178

Abstract

The brain ischemia due to vascular occlusion, especially in the main cerebral artery, could trigger the microglia as a natural immune cell in the brain. These activated microglia will turn up the inflammation cascade in the ischemic area. Interleukin-4 (IL-4) has a vital role in the microglial alteration to become an anti-inflammatory phenotype, which wind up the expression of MHC II and CD11c. Moreover, previous studies has supported that the stimulation of IL-4 in the culture of microglia/macrophage will produce this kind of “alternative” phenotype or neuroprotective phenotype, through the fall of TNF and rise of IGF-1. However, only a few have discussed the role and profile of IL-4 in ischemic stroke. This review article will cover the possibility of IL-4 role as an anti-inflammatory predictor in ischemic stroke.Keywords: Interleukin-4, microglia, ischemic stroke, inflammation
The Relationship Between Brain Tumor And Sleep Components (Psqi) In Siloam Hospitals Lippo Village 2015-2018 Uranus, Hans Christian; July, Julius
Medicinus Vol. 8 No. 2 (2019): February : 2019
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v7i4.2384

Abstract

Introduction: Brain tumor can cause symptoms such as headache and seizure which might reduce sleep quality. Currently, sleep quality in brain tumor patients aren’t getting much attention. This study’s purpose is to determine the effect of brain tumor to sleep quality and its components in patients.Methods: The design of this study is a retrospective cohort, and it is done in Siloam Hospitals Lippo Village and Paviliun Umum Rumah Sakit Siloam from January-April 2019 with sample population consisting of brain tumor patients from age 19 until 59 years old. The sample amount is 29 subjects. PSQI is used to assess sleep quality and components. Data analysis uses the SPSS version 24.0 software and statistical  analysis using chi2.Result: Brain tumor patients have worse sleep quality compared to the control, with 26 patients (89.7 %) having bad sleep quality. For the control, there are only 18 people (62.1%) who have bad sleep quality. The relationship between brain tumor and sleep quality have a p value of 0.032 and relative risk (RR) of 3,7. Brain tumor has a significant relationship with sleep latency (p value 0,015) and daytime dysfunction (p value 0,02)Conclusion: The relationship between brain tumor and sleep quality in brain tumor patients of Siloam Hospitals Lippo Village and Paviliun Umum Rumah Sakit Siloam, which was measured with the PSQI questionnaire is significant. Brain tumor also has a significant relation with sleep latency and daily dysfunction.
Case Report: Management Penetrating Brain Injury Across Middle Third of Superior Sagittal Sinus Chumaidi, Achmad; July, Julius
Medicinus Vol. 12 No. 1 (2022): October
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v10i2.7025

Abstract

Background: Penetrating cranial injuries are rarely reported on thick parietal bone. Goal of its management include removal of the foreign object while minimizing furher damage to the brain and associated neurovascular structures, also prevent further complications.Case Description: We report a case of a 22-year-old male presented with machete stucked in his head following an accidentally fell down of the weapon from a coconut tree. The cranial location affected were midparietal. He was disoriented on admission, with neither neurological focal signs nor seizure. Computed tomography (CT) revealed that the object penetrate middle superior sagittal sinus. After emergency craniotomy to remove the objects, debridement, dural sinus repair were performed. Recovery was complete without sequelae.Conclusion: Laceration of the middle thirds of the superior sagittal sinus require special handling and care during surgery. Operative approach and treatment strategies are among the most important considerations to achieve the best patient outcomes. 
Intramedullary Spinal Cord Cavernoma: A Case Report and Literature Review Widjaya, Ingrid A; Yunus, Yesaya; Wahjoepramono, Eka Julianta; July, Julius
Medicinus Vol. 13 No. 1 (2023): October
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v11i2.7533

Abstract

Background: Spinal cord intramedullary cavernous malformation (SICM) is kind of rare vascular disease, and the therapeutic strategy is still under debate. Cavernous malformation (CM) can be found throughout the central nervous system (CNS) but only rarely occur within the spinal cord. The purpose of this article is to describe natural history, clinical presentation and outcome of SICM case which treated surgicallyCase Presentation: A 70-year-old healthy woman presented with lower extremity weakness. A posterior laminectomy was performed, and a diagnosis of intramedullary spinal cord cavernous malformation was established. Neurological improvement was seen in one month after surgeryConclusion: Intramedullary CM is a rare disease but one with significant consequences if not managed appropriately. whenever safely feasible, gross total resection is suggested, to prevent rebleeding and further worsened of neurological deficit.
Co-Authors Abhijit Guha Achmad Chumaidi Achmad Chumaidi, Achmad Ahmad Faried Alexander Cahyadi, Alexander Anak Agung Istri Sri Wiadnyani Andi A. Islam Andi Asadul Islam As’ad, Suryani Beny Atmadja Wirjomartani Bilzardy Ferry Budhianto Suhadi Dermawan, Kevin Dong seok Lee Eka J. Wahjoepramono Harahap, Agnes S. Harsono, Ivan William Irawan Yusuf Ivan William Harsono Kristiani, Erna Lekatompessy, Michael Lucia Herminawati Lucia Herminawati, Lucia Maria F. Ham Marisca, Stephanie Mira Yuniarti Muhammad Zafrullah Arifin Nathania Victoria Stevina Novita Tirtaprawita Priscilla Muliantara Sophie Peeters Stevina, Nathania Victoria Suharyani, Sally Susanto, Eka Sutisna Himawan Tirtaprawita, Novita Tjahjadi, Hartono Uranus, Hans Christian Veli Sungono Vivien Puspitasari, Vivien Widjaya, Ingrid A Widodo, Stephanie T. Widyakrisna, Albertus Boyke Raditya Wiradharma Wiradharma Wiradharma Wiradharma, Wiradharma Yesaya Yunus Yesaya Yunus Yesaya Yunus